Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients

Home , Clarified butter, Ghee, Mustard oil, Rice bran oil

Food and Nutrition Sciences, 2013, 4, 1084-1093 Published Online November 2013 (http://www.scirp.org/journal/fns) http://dx.doi.org/10.4236/fns.2013.411141

Monika Choudhary, Kiran Grover, Jasvinder Sangha

Punjab Agricultural University, Ludhiana, India. Email: [email protected]

Received August 6th, 2013; revised September 6th, 2013; accepted September 13th, 2013

Copyright © 2013 Monika Choudhary et al. This is an open access article distributed under the Creative Commons Attribution Li- cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT The present study was designed to evaluate the effectiveness of blended rice bran and olive oil on hyperlipidemic subjects. A total of 60 moderately hyperlipidemic patients (Total Cholesterol (TC) >200 mg/dl and/or Triglycerides (TG) >150 mg/dl) with an age range of 45 - 60 were selected from Mediciti Hospital of Ludhiana and were divided into two groups: Group A and Group B containing 30 subjects each. The subjects of Group B were given blended rice bran and olive oil for a time period of 45 days and were asked to continue with their routine eating and physical activity pattern. The subjects of Group A were kept on their regular cooking oil. The serum lipid values were assessed before and after the study. Additional parameters assessed included anthropometry, dietary fat intake and physical activity pattern. The results showed that there was an insignificant change in the average body mass index (BMI) of the subjects of Group B before (27.0 kg/m2) and after (26.9 kg/m2) the study respectively. Also, there was an insignificant change in the lipid levels of the subjects of Group B after the study. The levels of TC and LDL cholesterol decreased by 3.7 and 9.0 percent respectively. Whereas, the levels of TG and VLDL cholesterol increased by 9.5 percent in the subjects of Group B after the feeding trials. Further, systolic and diastolic blood pressure of the subjects of Group B reduced by 2.9 and 2.3 percent respectively. An insignificant change was observed in all the parameters of selected subjects. So, the present study recommends carrying out more long duration research studies to evaluate the effectiveness of this blended oil.

Keywords: Blended Rice Bran and Olive Oil; Hyperlipdemia; Lipid Profile

1. Introduction The quantity and quality of a dietary fat play a crucial role in the plasma cholesterol and lipid levels [4]. To India is on the threshold of an epidemic of cardiovascular maintain aesthetic quality of vegetable oil, blending of disease, and surveys in urban areas show that coronary oils is gaining popularity worldwide due to its advan- risk factors are widespread [1]. Hyperlipidemia is an es- tages like improved thermal stability, oxidative stability, tablished major risk factor for coronary artery disease and nutritional benefits [5]. The traditional cooking oils and has become a preeminent target for reducing cardio- used in India include mustard, coconut, palm olein, vascular risk [2]. Lifestyle risk factors, especially dietary groundnut, safflower and sunflower oil, while newer oils habits, have a substantial effect on hyperlipidemia. Nu- include soybean oil, rice bran oil, and olive oil. Several merous studies in both animals and humans demonstrated research studies have demonstrated the quality and prop- that the saturated fatty acids and cholesterol in the diet erties of blended oils like sunflower and rice bran oil, are the primary determinants of diet-induced hyperlipi- sunflower and palm olein oil, soybean and palm olein oil, demia. Overtime considerable research has been directed rice bran and mustard oil, coconut and groundnut oil, towards dietary manipulation that can positively reduce sesame and coconut oil [5,6]. But, no study has been re- serum lipid levels resulting in the lowering of cardiovas- ported to document the health benefits of blended rice cular risk. The American Heart Association (AHA) Guide- bran and olive oil. lines, for instance, have emphasized on dietary choles- Rice bran oil (RBO) has been investigated for its terol and fat reduction as a first step for treating hyper- chemical, nutritional and toxicological properties and has cholesterolemia [3]. been found to be safe for human consumption. RBO,

Open Access FNS Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients 1085 with its unsaponifiable matter, which is rich in phytos- nor smokers and were not taking medication known to terols, gamma oryzanol and total tocopherol, has been affect plasma lipid levels. Frequent travelers, subjects shown to have blood cholesterol-lowering properties who frequently ate out, subjects who were using rice compared with other oils, in both animals and humans bran oil and olive oil as regular cooking media were also [7,8]. Olive oil (OO) contains a wide variety of valuable excluded from participation in the study. The research antioxidants and is also rich in monounsaturated fatty was approved by the appropriate committee of the insti- acids (67.0%). Studies have also proved that consump- tution and an informed written consent was obtained tion of olive oil can provide heart health benefits such as from all the subjects who participated in the trial and favorable effects on cholesterol regulation and LDL cho- they were explained in detail the study protocol and the lesterol oxidation and it also exerts anti-inflammatory, other requirements, including number of visits to be antithrombotic, antihypertensive as well as vasodilatory made to the hospital during the study, strictly adhering to effects both in animals and in humans [9,10]. the cooking oil samples supplied etc. The present investigation was undertaken, to study the effect of blended rice bran and olive oil (RBO + OO) 2.3. Experimental Protocol (70:30 ratio with oryzanol and alpha tocopherol equiva- To evaluate the effectiveness of blended oil, selected lent) on human subjects with hyperlipidemia when the oil subjects (N = 60) were divided into two groups—Group was introduced into a household. Besides dietary intake A (Control) and Group B (Experimental) containing 30 of oils, since several lifestyle factors including sedentary subjects each (n = 30). RBO + OO (70:30) was procured life, lack of exercise and inappropriate diet, are also from the Tara Health Foods Limited (Sangrur, Punjab, known to affect lipid profile in humans. Hence, lifestyle factors were also assessed during the study to isolate the India) in the containers (5 liters) without labelling. The effect of RBO + OO alone on hyperlipidemia. subjects of Group B were given RBO + OO and suffi- cient quantity of oil was distributed to fulfill the re- 2. Materials and Methods quirements of the whole family as per their regular intake and were asked to continue with their routine eating and 2.1. Selection of Blended Oil (RBO + OO) physical activity pattern. Test oil was given code and Under one parameter of our pilot study [11], we prepared subjects were not aware of the code. The subjects of Group six rice bran oil blends in two ratios i.e. 80:20 and 70:30 A were kept on their regular cooking oil. The experi- and analyzed for fatty acid composition, physicochemical mental period was carried out for a duration of 45 days. properties, oxidative stability, and antioxidant activity. Consequently, RBO + OO (70:30) contained 19 percent 2.4. Lifestyle Assessment SFA, 47.6 percent MUFA and 33.4 percent PUFA re- Information about the subjects pertaining to age, educa- spectively. In terms of physicochemical properties RBO tion, occupation, family composition and socio-economic + OO (70:30) showed appropriate smoke point (200˚C) status was collected using the pretested interview sched- and frying temperature (175˚C), and had low acid value ule. Physical Activity Diary Method (PADM) was used (0.19 mg KOH/g) as well as a low percentage of free to record the time spent on different activities. Physical fatty acids (0.09%). Also, in terms of oxidative stability Activity Ratios (PAR) given by FAO/WHO/UNU was and antioxidant activity, RBO + OO (70:30) showed least used to assess the physical activity level of the subjects percent increase (30.3%) in peroxide formation after 28 [12]. Dietary survey was carried out to get information days of incubation period and had the highest content of about a type of oil consumed, adequacy of fat including total natural antioxidants (2525.0 mg/kg) and highest visible fat and invisible fat, total quantity of visible and radical scavenging activity (67.7%). invisible fat consumed by subjects. The required fatty acid ratios were also calculated to know the risk ratio. 2.2. Selection of Subjects The 24 hour food recall method for 3 consecutive days A total of 60 moderately hyperlipidemic (Total Choles- was used to assess the dietary intake of subjects. The terol (TC) >200 mg/dl and/or Triglycerides (TG) >150 average daily intake of nutrients was calculated using the mg/dl) with an age range of 45 - 60 years, visiting dietary Indian Nutrition Software (Diet Soft). department for counselling, were selected from Mediciti The fat intake was compared with the recommended Hospital of Ludhiana, after they provided a medical his- dietary allowances given by Indian Council of Medical tory, underwent a physical examination, and had a clini- Research (ICMR) [13]. According to ICMR, dietary fat cal blood analysis performed before enrollment in the should provide a minimum of 20 percent of energy in a study. The subjects had no evidence of any chronic ill- normal diet, which ensures <10 per cent energy from ness, including diabetes, hepatic, renal, thyroid, or car- saturated fatty acids (SFAs), and 6 - 10 per cent energy diac dysfunction. They were neither chronic alcoholics from polyunsaturated fatty acids (PUFAs) and 9 - 15 per

Open Access FNS 1086 Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients cent energy from monounsaturated fatty acids (MUFAs) Table 1. Background information of the selected subjects (n with an optimum ratio of SFA, MUFA and PUFA i.e., = 30). 1:1.5:1. The quality of dietary fat should be such that it Group A Group B Characteristics furnishes PUFA/SFA (P/S) and linoleic acid (n6)/lino- (control) (experimental) lenicacid(n3) (n6/n3) between 0.8 - 1.0 and 5 - 10, respec- Age (years) tively. Various anthropometric parameters viz. height, 45 - 50 7 (23.3) 4 (13.3) weight, triceps skin fold thickness (TSFT), mid upper 50 - 55 8 (26.7) 9 (30.0) arm circumference (MUAC), waist and hip circumfer- 55 - 60 15 (50.0) 17 (56.6) ence were recorded using standard methods [14]. Body Education Mass Index (BMI) and waist-hip ratio was also calcu- Matric (up to 10th standard) 17 (56.6) 15 (50.0) lated. Above matric 13 (43.3) 15 (50.0) 2.5. Biochemical Analysis Occupation Business 6 (20.0) 4 (13.3) A minimum of 15 ml of fasting blood samples were ob- Service 24 (80.0) 26 (86.6) tained for lipid profile determinations in an EDTA vacu- Family size tainer by trained personnel under aseptic conditions from <5 21 (70.0) 22 (73.3) all subjects before and after the experimental period and ≥5 9 (30.0) 8 (26.7) analyzed for Serum Triglycerides (TG) [15], Total cho- Family income/month (Rs.) lesterol (TC) [16] and high density lipoprotein choles- 20,000 - 40,000 8 (26.7) 12 (40.0) terol (HDL-C) [17] by automated methods. Serum low density lipoprotein cholesterol (LDL-C) was calculated 40,001 - 60,000 8 (26.7) 5 (16.7) from primary measurements using the empirical formula ≥60000 14 (46.6) 13 (43.3) of by Friedwald [18] equation according to which LDL Figures in parenthesis are percentages. cholesterol = Total cholesterol—(HDL cholesterol + VLDL cholesterol) whereas very low density lipoprotein was reported as the major activity performed by the sub- cholesterol (VLDL-C) was estimated as triglyceride di- jects. The average time spent on sleeping was reported as vided by 5. Systolic (SBP) and diastolic blood pressure 464.0 and 496.0 minutes by the subjects in Group A and (DBP) was also recorded using a sphygmomanometer. Group B respectively. Sitting was the second major activity performed by the subjects. The average time spent 2.6. Statistical Analysis on sitting was reported as 362.0 and 402.0 minutes by the subjects in Group A and Group B respectively. The time Data were statistically analyzed by CPCS1. Student’s spent on sleeping and sitting by the subjects of Group B t-test and paired t-test were used to test the significant (p was insignificantly more as compared to the subjects in < 0.05) differences between variables. Relevant coeffi- Group A. The third major activity performed by the sub- cients of correlations were also computed. jects was light leisure activity like watching television and chatting. Walking at varying places without a load 3. Results and Discussion was the fourth major activity performed by the subjects. Background information of the subjects is given in Table The average time spent on this activity by subjects of 1. The data revealed that the majority of subjects be- Group B (176.0 minutes) was observed insignificantly longed to the age group of 55 to 60 years and were stud- more as compared to the subjects of Group A (120.0 ied up to matric. The majority of the subjects was doing minutes). An insignificant difference was observed in the service as their major occupation. The data further re- time spent on different activities performed by the sub- vealed that most of the subjects had family incomes jects in both groups. Physical activity level (PAL) is the above Rs. 60,000 on monthly basis. energy requirement expressed as a multiple of 24-hour BMR. The data revealed that most of the subjects in 3.1. Physical Activity Pattern Group A (70.0%) and Group B (66.6%) were falling in the sedentary or light activity lifestyle on the basis of Physical activity pattern of the subjects was divided into their PAL i.e., 1.53 and 1.54 respectively. In contrast, pre- ten activities viz. sleeping, personal care, eating, sitting, vious study reported a higher value of PAL i.e. 1.6 [19]. general household work, driving a car to/from work, light leisure activity (Television, Chatting), low intensity aero- 3.2. Dietary Fat Intake bic exercise, non mechanized agriculture work and walking at varying places without a load (Table 2). The data regarding the type and frequency of fat/oil con- The time of activities is presented in minutes. Sleeping sumed by the subjects is giv en in Table 3. The survey

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Table 2. Physical activity pattern of the selected subjects (n = 30).

Time spent on different physical activities (minutes) Activities (PAR)* t-value between 1 & 2 Group A (control) 1 Group B (experimental) 2 Sleeping (1) 464.0 ± 9.2 496.0 ± 8.7 NS Personal care (2.3) 68.0 ± 3.6 60.0 ± 0.0 NS Eating (1.5) 45.0 ± 2.8 60.0 ± 0.0 NS Sitting (1.5) 362.0 ± 18.1 402.0 ± 13.7 NS General household work (2.8) 58.0 ± 2.0 0 NS Driving car to/from work (2) 81.0 ± 17.5 49.0 ± 6.0 NS Light leisure activity (TV, Chatting) (1.4) 224.0 ± 14.3 178.0 ± 6.2 NS Low intensity aerobic exercise (4.2) 2.0 ± 1.4 19.0 ± 4.9 NS Non mechanized agriculture work (4.1) 16.0 ± 16.2 0 NS Walking at varying places without a load (3.2) 120.0 ± 15.9 176.0 ± 18.7 NS Group A Group B t-value between 1 & 2 Physical activity level (PAL) rural (n = 100) Subjects (%) PAL 1 Subjects (%) PAL 2 Sedentary (1.40 - 1.69) 21(70.0) 1.53 ± 0.2 20 (66.6) 1.54 ± 0.0 NA Moderate (1.70 - 1.99) 8 (26.6) 1.74 ± 0.4 10 (33.3) 1.76 ± 0.1 NA Vigorous (2.00 - 2.40) 1 (3.33) 2.25 ± 0.0 0 (0.0) 0 NA Total 30 (100) 1.62 ± 0.3 30 (100) 1.61 ± 0.1 NS Values are given as Mean± SE; *Physical activity ratios (PAR); ●Significant at 5% level of significance; NS: No significant difference; NA: Not applicable.

Table 3. Type and frequency of fat/oil consumed by the selected subjects (n = 30).

Type of fat/oil Group A (control) Group B (experimental) Mustard oil 2 (6.7) 4 (13.3) Desi ghee + mustard oil 7 (23.3) 9 (30.0) Mustard oil + soybean oil 6 (20.0) 4 (13.3) Butter + desighee + mustrad oil 0 (0.0) 2 (6.7) Desighee + mustard oil + soybean oil 2 (6.7) 3 (10.0) Desighee + mustard oil + sunflower oil 7 (23.3) 4 (13.3) 6 (20.0) 4 (13.3) Frequency of fat/oil consumed Group A (Control) Type of fat/oil Daily Weekly Fortnightly Monthly Twice/thrice Once Butter 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Desi ghee 15 (50.0) 3 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) Hydrogenated fat 0 (0.0) 0 (0.0) 2 (6.7) 0 (0.0) 0 (0.0) Mustard oil 13 (43.3) 17 (56.6) 0 (0.0) 0 (0.0) 0 (0.0) Soybean oil 4 (13.3) 9 (30.0) 0 (0.0) 0 (0.0) 0 (0.0) Sunflower oil 0 (0.0) 6 (20.0) 0 (0.0) 0 (0.0) 0 (0.0) Group B (Experimental) Type of fat/oil Daily Weekly Fortnightly Monthly Twice/thrice Once Butter 2 (6.7) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Desi ghee 15 (50.0) 7 (23.3) 0 (0.0) 0 (0.0) 0 (0.0) Hydrogenated fat 0 (0.0) 3 (10.0) 0 (0.0) 0 (0.0) 0 (0.0) Mustard oil 10 (33.3) 20 (66.7) 0 (0.0) 0 (0.0) 0 (0.0) Soybean oil 0 (0.0) 8 (26.6) 0 (0.0) 0 (0.0) 0 (0.0) Sunflower oil 0 (0.0) 4 (13.3) 0 (0.0) 0 (0.0) 0 (0.0) Figures in parenthesis are percentages.

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data revealed that desi ghee+ mustard oil was the most age total fat intake by the subjects of Group A and Group common combination of fat/oil consumed by the 30 per- B was 70.3 and 82.7 g/day respectively. After the study cent of the subjects in Group B whereas in Group A, desi the corresponding figures were 79.3 and 79.9 g/day by ghee + mustard oil and desighee + mustard oil+ soybean the subjects of Group A and Group B with the percent oil were the most common combinations of fat/oil con- contribution of 33.2 and 31.4 to the total energy intake sumed by the 23.3 percent of the subjects prior to the respectively (Figure 1). The findings of the study were study. Desi ghee is a class of clarified butter that is rich in line with previous studies which reported that the av- in SFA (65%) [20]. In terms of frequency also, desi ghee erage total fat intake by the adult males was 61.0 g/day and mustard oil were the most frequently consumed [22]. In contrast, an another study reported a lower value fat/oil by the subjects. The data depicted that 56.6 and of average total fat intake (48 - 54 g/day) by the adults in 66.7 percent of the subjects in Group A and Group B Punjab. An insignificant change was observed in the total used to consume mustard oil once a day respectively fat intake by the subjects in both groups. Though the total whereas 50.0 percent of the subjects in both groups used fat intake by the subjects in both groups was higher than to consume desi ghee twice/thrice daily. The survey data the recommendations (33.3 g/day) but the SFA:MUFA: of the previous studies also revealed that desi ghee and PUFA of the subjects in Group A (1:1.1:0.9) was found mustard oil were the most frequently used fat/oil in the to be close to the recommendations given by ICMR and urban and rural area of Punjab [21]. n6/n3 (6.7) was found to be within the suggested range (5 The data pertaining to average daily intake of energy, - 10) before the study. Whereas, the subjects of Group B total fat, fat fractions and different ratios by the subjects had SFA:MUFA:PUFA (1:1.1:0.7) close to the recom- is presented in Table 4. It was observed that initial aver- mendations after the study.

Table 4. Mean daily fat intake of the selected subjects (n = 30).

Nutrient Before 1 After 2 % change Paired t-value between 1 & 2 Suggested intake Group A (control) Energy (Kcal) 2157 ± 69.8 2152 ± 72.1 0.2 NS 1500 Total fat (g) 70.3 ± 6.6 79.3 ± 4.9 11.3 NS 33.3 Visible fat (g) 42.7 ± 5.9 49.8 ± 4.1 14.3 NS 16.7 Invisible fat (g) 27.6 ± 4.2 29.5 ± 3.8 6.4 NS 16.7 SFA (g) 22.2 ± 1.4 33.6 ± 2.4 33.9 NS <16.7 MUFA (g) 25.5 ± 1.8 27.6 ± 1.3 7.6 NS 15 - 25 PUFA (g) 20.8 ± 3.1 15.2 ± 0.6 26.9 NS 10 - 16.7

n6 (g) 18.1 ± 3.1 12.0 ± 0.7 33.7 NS 8.3 - 13.3

n3 (g) 2.7 ± 0.4 3.2 ± 0.4 15.6 NS 1.7 - 3.3 Trans fats (g) 1.8 ± 0.1 2.9 ± 0.1 37.9 NS <1.7 P/S 0.9 ± 0.1 0.4 ± 0.3 55.6 NS 0.8 - 1 SFA:MUFA:PUFA 1:1.1:0.9 1:0.8:0.5 - NA 1:1.5:1

n6/n3 6.7 ± 4.1 3.8 ± 0.1 43.9 NS 5 - 10 Group B (experimental) Energy (Kcal) 2325 ± 74.5 2291 ± 75.6 1.5 NS 1500 Total fat (g) 82.7 ± 4.7 79.9 ± 4.9 3.4 NS 33.3 Visible fat (g) 45.0 ± 2.9 45.0 ± 2.9 0.0 NS 16.7 Invisible fat (g) 37.7 ± 3.2 34.9 ± 2.7 7.4 NS 16.7 SFA (g) 37.6 ± 2.2 28.4 ± 2.3 24.4 NS <16.7 MUFA (g) 27.0 ± 1.6 31.2 ± 2.0 13.5 NS 15 - 25 PUFA (g) 15.6 ± 0.8 19.3 ± 1.1 19.2 NS 10 - 16.7

n6 (g) 11.8 ± 0.7 18.6 ± 1.1 36.6 NS 8.3 - 13.3

n3 (g) 3.6 ± 0.2 0.6 ± 0.1 83.3 9.9 1.7 - 3.3 Trans fats (g) 2.5 ± 0.3 1.0 ± 0.3 60.0 5.3 <1.7 P/S 0.4 ± 0.8 0.7 ± 0.0 42.9 NS 0.8 - 1 SFA:MUFA:PUFA 1:0.7:0.4 1:1.1:0.7 - NA 1:1.5:1

n6/n3 3.2 ± 0.4 31 ± 4.0 89.7 9.9 5 - 10 Values are given as Mean ± SE; Significant at 5% level of significance; NS: No significant difference; NA: Not applicable.

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Figure 1. Percent contribution of fat fractions to the total energy intake of the selected subjects (n = 30).

The improvement in the ratio could be due the intake source of invisible fat in the diets of the subjects fol- of blended rice bran and olive oil as after the experimen- lowed by cereals and pulses. The respective contribution tal period, the intake of SFA decreased insignificantly by of milk and cereals and pulses was nearly 21.9 and 3.5 24.4 percent and the intake of MUFA and PUFA in- g/day by the subjects in Group A and 23.7 and 5.3 g/day creased insignificantly by 13.5 and 19.2 percent respec- by the subjects in Group B to the total invisible fat after tively. It was also observed that the intake of visible fat the study. These results were in contrast to the NNMB was same i.e. 45.0 g/day by the subjects of Group B be- data from other states where cereals and millets contrib- fore and after the feeding trials with the percent contribu- uted more fat due to low milk intake. The contribution of tion of 17.4 to the total energy intake. The reported value invisible fat to the total fat was lesser than visible fat of visible fat intake was in accordance with the findings intake by the subjects in both groups. of a recent study in which the corresponding figure was The percent adequacies of all the fat fractions of the 47.7 g/day [22]. In contrast, Kaur et al [23] reported a subjects in both groups (except the percent adequacy of lower value of visible fat intake i.e. 30 - 40 g/day by the n3 (24.0) and trans fat (58.8) of the subjects in Group B) adult males. In comparison to the subjects of Group A, were recorded to be higher than the 100 percent which the n6/n3 (31.0) of the subjects of Group B was found to depicted the high intake of dietary fat by the subjects in be higher than the suggested range (5 - 10) after the study both groups before and after the study (Figure 2). The as the intake of n6 increased insignificantly by 36.6 per- findings of the study were in line with previous study cent and the intake of n3 decreased significantly (p ≤ 0.05) [23]. by 83.3 percent respectively. This could be due to the absence of n3 in the blended rice bran and olive oil. The 3.3. Anthropometric Profile intake of trans fats was also decreased significantly (p ≤ 0.05) by 60.0 percent after study in the subjects of Group The anthropometric profile of the selected subjects is B. presented in Table 5. Body mass index (BMI) is a simple Further, it was observed that invisible fat intake by the index of weight-for-height that is commonly used to subjects in Group A and Group B was 27.6 and 37.7 classify overweight and obesity in adults [24]. An insig- g/day with the percent contribution of 11.5 and 14.6 to nificant change was observed in the average BMI of the the total energy, respectively before the study. The cor- subjects in Group A and Group B before (27.8 and 27.0 responding figures changed to 29.5 and 34.9 g/day with kg/m2) and after (27.8 and 26.9 kg/m2) the study respec- the percent contribution of 12.3 and 13.7 to the total en- tively. ergy, respectively after the study. Milk was the main The distribution of the selected subjects according to

Open Access FNS 1090 Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients

Figure 2. Percent adequacy of fat intake of the selected subjects (n = 30).

Table 5. Anthropometric profile of the selected subjects (n = 30).

Variables Before 1 After 2 % change Paired t-value between 1& 2 Suggested value

Group A (control) 18.5 BMI (kg/m2) 27.8 ± 0.8 27.8 ± 0.8 0.0 NS −24.99 TSFT (mm) 12.2 ± 0.1 12.1 ± 0.1 0.8 NS 12.5

MUAC (cm) 28.9 ± 1.0 28.9 ± 1.0 0.0 NS 29.3

Waist/hip ratio 1.0 ± 0.0 1.0 ± 0.0 0.0 NS 1.0

Group B (experimental) 18.5 BMI (kg/m2) 27.0 ± 0.7 26.9 ± 0.7 0.4 NS −24.99 TSFT (mm) 11.8 ± 1.1 10.9 ± 0.8 7.6 NS 12.5

MUAC (cm) 28.9 ± 0.7 28.9 ± 0.5 0.0 NS 29.3

Waist/hip ratio 1.0 ± 0.0 1.0 ± 0.0 0.0 NS 1.0

Values are given as Mean ± SE; NS: No significant difference. their BMI as per WHO classification is illustrated in (1.0) of the subjects in both groups was also in line with Figure 3. Most of the subjects in Group A (50.0%) and the standard value (1.0) as suggested by Ghafoorunissa Group B (53.3%) were categorized as overweight respec- and Krishnaswamy [26]. There were no significant chan- tively with a BMI range 25.00 - 29.99 kg/m2, more spe- ges in the anthropometric profile of the subjects in both cifically pre-obese (30.0 and 36.6 percent, respectively) groups before and after the study. with a BMI range 25.00 - 27.49 kg/m2 before and after the study. In contrast, previous studies reported an aver- 3.4. Biochemical Analysis age BMI of 30 kg/m2 [25]. An insignificant change was also observed in the TSFT and MUAC of the subjects in The clinical parameters of the selected subjects are pre- Group A and Group B but the values were lesser than the sented in Table 6 ([26]). There was an insignificant standard values in both groups. Similarly, waist/hip ratio change in the lipid levels of the subjects of the Group B

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Figure 3. Distribution of subjects according to their body mass index (kg/m2).

Table 6. Biochemical parameters of the selected subjects (n = 30).

Variables Before 1 After 2 % change Paired t-value between 1& 2 Normal range (mg/dl)

Group A (control)

TC 193.5 ± 4.9 203.8 ± 6.7 5.1 NS <200

TG 225.7 ± 17.3 263.9 ± 17.2 14.5 NS <150

HDL-C 41.5 ± 0.4 42.1 ± 0.4 1.4 NS <50

LDL-C 107.1 ± 2.0 109.0 ± 4.0 1.7 NS <130

VLDL-C 44.9 ± 3.4 52.7 ± 3.5 14.8 NS <30

TC/HDL-C 4.7 ± 0.1 4.8 ± 0.1 2.1 NS <4

LDL-C/HDL-C 2.6 ± 0.1 2.6 ± 0.1 0.0 NS <3

SBP 147.9 ± 5.1 137.8 ± 5.4 6.8 NS 140

DBP 92.1 ± 3.3 87.8 ± 3.4 4.7 NS 90

Group B (experimental)

TC 205.5 ± 7.1 197.8 ± 6.1 3.7 NS <200

TG 210.5 ± 15.3 232.7 ± 19.0 9.5 NS <150

HDL-C 42.8 ± 0.5 41.7 ± 0.5 2.6 NS <50

LDL-C 120.6 ± 6.1 109.7 ± 4.2 9.0 NS <130

VLDL-C 42.1 ± 3.1 46.5 ± 3.8 9.5 NS <30

TC/HDL-C 4.8 ± 0.1 4.7 ± 0.1 2.1 NS <4 LDL-C/HDL-C 2.8 ± 0.1 2.6 ± 0.1 7.1 NS <3 SBP 138.3 ± 4.5 134.3 ± 3.8 2.9 NS 140 DBP 87.3 ± 2.8 85.3 ± 2.5 2.3 NS 90

Values are given as Mean ± SE; NS: No significant differences.

Open Access FNS 1092 Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients

after the study. It was found that the use of blended rice other family members from developing cardiovascular bran and olive oil (Group B) as the main cooking oil for diseases. In our study, the oil was well accepted with a period of 45 days reduced the levels of TC and LDL-C good compliance. RBO is also a cheaper oil than other by 3.7 and 9.0 percent respectively. The hypocholestrol- oils available in the market. So, blended rice bran and aemic activity of blended oil could be due to the presence olive oil (70:30 with 2275.5 ppm oryzanol), in view of its of oryzanol (2275.5 ppm) and oleic content (47.6%) of hypolipidemic effect, could be considered beneficial for RBO + OO. Oryzanol may inhibit the absorption of cho- patients with lipid abnormalities as a means to maintain lesterol and may increase the faecal excretion of bile ac- normal levels of lipids. It was a pilot study in which the ids [27]. Oleic acid had been described to reduce the car- blend of RBO and OO was used for the first time. So, diovascular risk by reducing blood lipids, mainly choles- more long duration research studies need to be carried terol [28,29]. Our study has confirmed the results of pre- out to evaluate the effectiveness of this blended oil. vious studies, which demonstrated that RBO reduced the total cholesterol when used as the main cooking oil. 5. Acknowledgements However, the decline in serum cholesterol observed in the previous study after a period of 90 days 8 percent as We are thankful to the Tara Health Foods Limited (San- compared to 3.7 percent in our study. Whereas, the levels grur, Punjab, India) for providing blended oil (RBO + of TG and VLDL-C increased by 9.5 percent in the sub- OO) at free of cost for research purpose. jects of Group B after the feeding trials. Indians worldwide have been shown to have a triad of high TGs with REFERENCES low HDL levels and high LDL levels [30]. These results were in contrast to the previous studies which showed 30 [1] K. S. Reddy, “The Emerging Epidemic of Cardiovascular Disease in India,” In: P. Shetty and C. Gopalan, Eds., to 35 percent decline in TG levels. In addition, the Diet, Nutrition and Chronic Disease: An Asian Perspec- amount of edible oil used by the subjects in the previous tive, Smith-Gordon, Bedford, 1998, pp. 50-54. studies was mentioned as 35 - 39 g/day [31,32] whereas [2] S. A. Bhatnagar, K. P. Kumar, J. Hemavathy and G. A. the corresponding figure in the present study was 45.0 Krishna, “Fatty Acid Composition, Oxidative Stability g/day. In another study, fat contributed about 24 percent and Radical Scavenging Activity of Vegetable Oil Blends to the total energy as compared to the 31.4 percent con- with Coconut Oil,” Journal of the American Oil Chem- tribution in our study. The ratio of LDL-C/HDL-C was ists’ Society, Vol. 86, No. 10, 2009, pp. 991-999. recorded to be 2.6 which was in accordance with the [3] A. Kennedy, D. S. Menon and E. Suneetha, “Study on suggested value (<3) given by the American Heart Asso- Effect of Rice Bran and Sunflower Oil Blend on Human ciation [33] but the ratio of TC/HDL-C (4.7) was higher Lipid Profile,” Indian Journal of Applied & Pure Biology, than the recommendations (<4). Further, systolic and Vol. 25, No. 2, 2010, pp. 375-384. diastolic blood pressure of the subjects of Group B re- [4] N. Frank, M. F. Andrews, B. S. Elliott, J. Lew and C. R. duced by 2.9 and 2.3 percent respectively. Boston, “Effects of Rice Bran Oil on Plasma Lipid Con- centrations, Lipoprotein Composition, and Glucose Dy- namics in Mares,” Journal of Animal Science, Vol. 83, 4. Conclusions No. 11, 2005, pp. 2509-2518. Our study showed that RBO+OO when was used as the [5] B. M. Siddique, A. Ahmed, H. M. Ibrahim, S. Hena, M. main cooking oil had lipid lowering effects. The fatty Rafatullah and A. K. Omar, “Physico-Chemical Proper- acid composition (SFA:MUFA:PUFA) of the RBO + OO ties of Blends of Palm Olein with Other Vegetable Oils,” (1:2.5:1.7) along with the minor components (2525.0 Grasas Y Aceites, Vol. 61, No. 4, 2010, pp. 423-429. http://dx.doi.org/10.3989/gya.010710 ppm) of the unsaponifiable fraction may be acting syner- gistically to produce hypocholesterolaemic action, indi- [6] N. H. Khan, S. J. Khan, S. Ali, K. Hussain, S. M. Alam and A. Habib, “Development of Some New Micronutrient cating that the hypocholesterolaemic activity of a dietary Rich Blends of Edible Vegetable Oils,” Current Botany, fat depends not only on fatty acid content of the oil, but Vol. 2, No. 5, 2011, pp. 16-19. also minor components of the unsaponifiable fractions. [7] M. M. Most, R. Tulley, S. Morales and M. Lefevre, “Rice We did only one baseline estimation of lipids. We realize Bran Oil, Not Fiber, Lowers Cholesterol in Humans,” that to arrive at a mean value, sequential measurements American Journal of Clinical Nutrition, Vol. 81, No. 1, of lipids are ideal and duration of the study should also 2005, pp. 64-68. be increased. The shortcoming of a single measurement [8] R. Kusum, H. Bommayya, P. Fayaz and H. D. Rama- is that there could be biological variations which could chandran, “Palm Oil and Rice Bran Oil: Current Status account for intra-individual variations. and Future Prospects,” International Journal of Plant In conclusion, RBO and OO have several advantages Physiology and Biochemistry, Vol. 3, No. 8, 2011, pp. and health benefits, so blend of these oils can be used 125-132. routinely as cooking oil. It could also help in preventing [9] M. I. Covas, “Olive Oil and the Cardiovascular System,”

Open Access FNS Effect of Blended Rice Bran and Olive Oil on Cardiovascular Risk Factors in Hyperlipidemic Patients 1093

Pharmacological Research, Vol. 55, No. 3, 2007, pp. 1, 2007, pp. 112-114. 175-186. http://dx.doi.org/10.1016/j.phrs.2007.01.010 [23] A. R. Kaur, M. Nagi and T. Gulati, “Lipid Profile in Re- [10] R. Turner, N. Etienne and G. M. Alonso, “Antioxidant lation to Type and Adequacy of Fat Consumed by Adult and Anti-Atherogenic Activities of Olive Oil Phenolics,” Punjabi Males: A Case Study,” Journal of Research, Pun- International Journal of Vitamin and Nutrition Research, jab Agricultural University, Vol. 45, No. 1-2, 2008, pp. Vol. 75, No. 1, 2005, pp. 61-70. 91-95. http://dx.doi.org/10.1024/0300-9831.75.1.61 [24] WHO Expert Consultant, “Appropriate Body-Mass Index [11] M. Choudhary, K. Grover and G. Kaur, “Fatty Acid Com- for Asian Population and Its Implications for Policy and position, Oxidative Stability, and Radical Scavenging Ac- Intervention Strategies,” The Lancet, Vol. 363, No. 9403, tivity of Rice Bran Oil Blends,” International Journal of 2004, pp. 157-163. Food and Nutritional Sciences, Vol. 2, No. 1, 2013, pp. http://dx.doi.org/10.1016/S0140-6736(03)15268-3 33-43. [25] Y. Ma, W. Li, B. C. Olendzki, S. L. Pagoto, P. A. Mer- [12] FAO, “Energy Costs of Activities,” In: Human Energy riam, D. E. Chiriboga, J. A. Griffith, J. Bodenlos, Y. Requirements: Report of a Joint FAO/ WHO/UNU Expert Wang and I. S. Ockene, “Dietary Quality 1 Year after Consultation, FAO Food and Nutrition Technical Report Diagnosis of Coronary Heart Disease,” Journal of the Series No. 1, FAO, Rome, 2004, pp. 92-96. American Dietetic Association, Vol. 108, No. 2, 2008, pp. [13] Indian Council of Medical Research, “Nutrient Require- 240-246. http://dx.doi.org/10.1016/j.jada.2007.10.047 ments and Recommended Dietary Allowances for Indi- [26] Ghafoorunissa and K. Krishnaswamy, “Dietary Prescrip- ans,” National Institute of Nutrition, Hyderabad, 2010. tions,” In: Diet and Heart Diseases, 2007, pp. 21-37. [14] D. B. Jelliffe, “The Assessment of Nutritional Status of [27] A. Berger, D. Rein, A. Schäfer, I. Monnard, G. Gremaud, Community,” WHO, Geneva, 1966. P. Lambelet and C. Bertoli, “Similar Cholesterol-Lower- [15] P. Fossati and L. Principle, “Qualitative Determination of ing Properties of Rice Bran Oil, with Varied Gamma- Triglycerides in Serum or Plasma by Enzymatic DHBC Oryzanol, in Mildly Hypercholesterolemic Men,” Euro- Colorimetric Method,” Clinical Chemistry, Vol. 28, No. pean Journal of Nutrition, Vol. 44, No. 3, 2005, pp. 163- 10, 1982, p. 2077. 173. http://dx.doi.org/10.1007/s00394-004-0508-9 [16] W. Richmond, “Qualitative Determination of Cholesterol [28] E. Lopez-Huertas, “Health Effects of Oleic Acid and in Serum or Plasma by Enzymatic Method,” Clinical Long Chain Omega-3 Fatty Acids (EPA and DHA) En- Chemistry, Vol. 19, No. 12, 1973, p. 1350. riched Milks. A Review of Intervention Studies,” Phar- macological Research, Vol. 61, No. 3, 2010, pp. 200-207. [17] M. F. Lopes-Virella, P. Stone, S. Ellis and J. A. Cohwel, http://dx.doi.org/10.1016/j.phrs.2009.10.007 “Qualitative Determination of HDL-Cholesterol in Serum or Plasma by Phospotungstate Method,” Clinical Chem- [29] A. M.Stephens, L. L. Dean, J. P. Davis, J. A. Osborne and istry, Vol. 23, No. 5, 1977, p. 882. T. H. Sanders, “Peanuts, Peanut Oil, and Fat Free Peanut Flour Reduced Cardiovascular Disease Risk Factors and [18] W. T. Frieldwalds, R. I. Levy and D. S. Friedrickson, the Development of Atherosclerosis in Syrian Golden “Estimation of Plasma or Serum Low Density Lipopro- Hamsters,” Journal of Food Science, Vol. 75, No. 4, 2010, tein Cholesterol Concentration without Use of Preparaline pp. 116-122. Ultracentrifuge,” Clinical Chemistry, Vol. 18, No. 6, http://dx.doi.org/10.1111/j.1750-3841.2010.01569.x 1972, p. 499. [30] H. S. Rissam, S. Kishore and N. Trehan, “Coronary Heart [19] R. Kuriyan, N. Gopinath, M. Vaz and V. A. Kurpad, “Use Disease in Young Indians—The Missing Link,” Indian of Rice Bran Oil in Patients with Hyperlipidemia,” The Academy of Clinical Medicine, Vol. 2, No. 3, 2001, pp. National Medical Journal of India, Vol. 18, No. 6, 2005, 128-132. pp. 292-296. [31] C. Rukmini and T. C. Raghuram, “Nutritional and Bio- [20] S. Johnson and N. Saikia, “Fatty Acids Profile of Edible chemical Aspects of the Hypolipidemic Action of Rice Oils and Fats in India,” 2009, pp. 1-42. Bran Oil: A Review,” Journal of American College of [21] U. Goyal, B. Sadana and S. Verma, “Contribution of Nutrition, Vol. 10, No. 6, 1991, pp. 593-601. Various Foods to Fat and Fatty Acids Intake among Ur- http://dx.doi.org/10.1080/07315724.1991.10718181 ban and Semi-Urban Women of Punjab,” Journal of Hu- [32] T. C. Raghuram and C. Rukmini, “Nutritional Signifi- man Ecology, Vol. 18, No. 3, 2005, pp. 217-220. cance of Rice Bran Oil,” Indian Journal of Medical Re- [22] P. M. Vijaylaxmi, B. Kasturiba, K. R. Naik and U. search, Vol. 102, Special Issue, 1995, pp. 241-244. Malagi, “Influence of Fats and Oils Intake on the Lipid [33] AHA, “Cholesterol Ratio—American Heart Association,” Profile of Adults Belonging to Different Income Groups,” 2004. http://www.americanheart.org Karnataka Journal of Agricultural Sciences, Vol. 20, No.

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